New app changes how brain disorders are treated: Interview Special

The company Trayt has launched an app that aims to improve diagnosis, treatments, and quality of life for patients with autism, ADHD, and other brain disorders through big data and analytics. To find out more we spoke with the company's founder.

Trayt is designed for caregivers and physicians who care for people with neurodevelopmental and other brain and behavioral disorders. The app is based on a unique and proprietary approach that uncovers connections between the brain, body and behavior of these patients. The program enables more accurate patient assessment, targeted treatments, and improved outcomes that can significantly reduce healthcare costs across the entire system of care.

Digital Journal: What are the main challenges facing parents caring for children with autism and ADHD?

Malekeh Amini: Parents face multiple challenges. First, parents and clinicians agree on one thing: No child with autism resembles another. Yet when a child is diagnosed with autism, they are sent home with one sheet of paper that provides the same roadmap for treatment for every patient. It includes only one type of treatment that is now believed to show efficacy for only 20-30% of patients. They are frustrated, overwhelmed and lack sufficient knowledge about the conditions to know that there are many other paths they can take for the care of their child.

Second, the diseases are complex and, in reality, are a combination of multiple diseases that are being treated independently. Parents are often overwhelmed by the complexity of the care required. They are also unaware of the potential interrelations of the various symptoms and the possible interactions of one treatment on other symptoms. This has led to poor outcomes and a very high cost of care, including a high out-of-pocket cost to families.

Third, managing multiple care providers that are not communicating directly – patients with these complex conditions are cared for by several physicians and multiple therapists, who are not connected. Parents are the central navigation for managing the care and often don’t have the knowledge or the tools to share the correct information with the right clinicians. This also has led to poor outcomes and a high cost of care across the system.

Fourth, lack of education and knowledge of factors impacting their child’s health has led to many poor care decisions for parents.

Fifth, as a result of chaos and poor decisions, outcomes are poor and patients continue to develop more severe symptoms over time. Given the life-long nature of many of the diseases, the complexity and cost of care for the adult patients continue to rise and poses overall challenges for those providing care.

DJ: What are the limitations with current treatments?

Amini: Autism and ADHD have many overlapping symptoms and the current misdiagnosis rate is estimated at over 30 percent, leading to poor treatments and outcomes, and a high cost of care.

Current treatments typicalyl take a trial-and-error approach. They treat all patients the same and ignore the overlap of multiple disorders and symptoms. This ignores the unique profiles of the condition that may respond better to specific treatments. Furthermore, most provide impact for children with neuro-disorders occurs before the age of 6. Proper diagnosis and early intervention are key to improving outcomes. The current system has challenges in both diagnosis and in treatment.

Also, patients are generally on a series of medications and treatments provided by multiple care providers. This has made it nearly impossible to measure the efficacy of any of the treatments and it has also led to frequent drug interaction complications in patients.

DJ: Why did you decide to develop the Trayt app?

Amini: I wanted to create a tool that provided a roadmap for families to properly care for the children and to improve children’s long-term health. The only way this was possible was to collect comprehensive and comorbid data on patients, create tools to measure outcomes, and share this data across the system of care. I had been in healthcare all my life and I knew this was a pain point for families that nobody seemed to be addressing.

Repetitively stacking or lining up objects is a behavior sometimes associated with individuals with autism.

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DJ: What features does the app offer?

Amini: The app provides a roadmap for care for families and a clinical decision support for physicians. Families can establish a comprehensive health profile for their child. The app’s intelligent engine then recommends achievable goals and suggests actions for families to improve the most challenging symptoms for their child. The app’s analytic engine continuously measures outcomes and progress, and continues to refine goals and actions to maintain on-going progress. Families can view this information and make care decision on a easy-to-use dashboard. Families can also share this information with their physicians so the entire team can coordinate and collaborate on care.

Another feature of the app that goes to the heart of the current pain point is its ability to create a comprehensive list of all treatments and remedies that families are using or that physicians are recommending. When the parent walks out of the diagnosis clinic with the one sheet of paper and the same single treatment path, they can now look at their Trayt app and view the hundreds of other options that are out there. They can also see which patient profiles seem to be using the various types of treatments and select the path that makes the most sense for their own child based on the child’s unique profile.

An important feature of the application is the “Comorbid Assessment,” which is a proprietary tool for assessing the patient’s symptoms based on intensity, frequency and duration. The assessment enables a more standardized and accurate measure of the patient’s health and progress.

DJ: How did you develop the app? Did you work with medical professionals?

Amini: I started working with Dr. Carl Feinstein of Stanford University as an advisor. After some initial discussions, Dr. Feinstein joined me as Trayt's chief medical officer and led the scientific and medical content and aspects that are the foundation of the app. We also have formal partnerships with key academic institutions and leading clinics to improve the content and the analytic engine of the application. We have used validated and evidence-based resources as the foundation for the content, including the DSM (Diagnostic and Statistical Manual of Mental Disorders) and other research conducted by thought-leading academic institutions.

DJ: What was the biggest challenge in developing the app?

Amini: We knew we needed data of both high quality and quantity to make this app valuable for improving overall treatments. In order to achieve that goal, we needed to be relevant to users and create an app that would keep families and physicians engaged on an on-going basis. Our ultimate goal is to improve our analytical engines and create predictive models for treating patients. We realized quickly that our immediate focus had to be on creating the right user experience and user interaction that would provide the data we need.

DJ: How did you address data security concerns?

Amini: Data privacy is our highest priority and concern, and data security is an element of that consideration. A key member of our team is our compliance officer, and has led all efforts concerning data privacy and security, including our cloud infrastructure. We have established dedicated instances on AWS. We ensure encryption at rest and in transit — on aggregate content and at individual record level. Our chief architect for the app comes to us from the security and IoT industry; his expertise is in creating, integrating and managing personal content at scale.

The app takes advantage of data analytics, has the analysis shown any trends of interest?

We are early in the process and we don’t have enough data to show trends that are statistically valid. We have however seen initial results in small populations that are encouraging. Where we have seen interesting trends is in day to day care and parent awareness. Once we roll-out our pilot program across a larger patient population, we hope to see these trends with more accuracy and publish those results.

DJ: What has the response been from parents?

Amini: We have seen overwhelming response from parents. The educational value, the daily roadmap for care, and the ability to measure outcomes and progress across the most challenging symptoms is what they have needed all along. It also validates their view that their child is unique and requires a more personalized plan for care.

DJ: How is the take-up of the app going?

Amini: We are have just launched the app and are engaging with an initial cohort of several hundred parents that meet our pilot-phase criteria. Then, we will expand the app’s availability much more broadly. The app is only the first step.

DJ: Are there any other projects that you are working on?

Amini: We are currently working on the Clinician Portal, which is a decision-support tool. Clinicians have real-time access to patient outcomes and they can make care decisions faster and with more accuracy, improving outcomes and reducing cost of care. Clinicians can also use the tool to measure overall outcomes within their clinic and create personal reports to help improve decisions for care based on patient profiles.

We are also working on a proprietary social platform that uses algorithms to engage families based on similarities. Lastly, we are also working on a clinical trial portal for pharmaceutical/biotech companies and for research institutes that are engaged in neuro-related therapeutics to collect outcomes data with more accuracy, faster and cheaper. This portal also has features that engage subjects within the clinical trial, resulting in higher retention rates and a significant reduction in costs for the clinical trial.